Watch out for glaucoma

Being visually impaired is a condition that one can be born with; however, health experts say there are certain lifestyles and conditions that could cause the condition. In fact, they say, people who develop such conditions don’t normally show signs or symptoms. The most common ailment, experts say, is glaucoma, a condition that causes damage to the eyes’ optic nerve and gets worse over time. Jean Damascene Nyankiko, a 52-year-old resident of Remera, was shaken when one day he woke up with blurred vision. He thought he had overslept and imagined it would be okay as the day went by. However, the condition with his eyes didn’t improve, but instead kept getting worse. “I didn’t have any signs or pain which could have prompted me to seek medical attention, everything was fine. After consulting a physician, I was told I have glaucoma,” he recalls. Although he started medication, his doctors say it’s not easy to treat the condition as it developed and is now in its advanced stage. Like Nyankiko, ophthalmologists say many people get this disease unknowingly; worse still, they seek medical attention when the condition is at an advanced stage. They say this complicates everything and that in most cases; it leaves one with a disability that could have been avoided if it was detected earlier. Dr John Nkurikiye, the chief consultant ophthalmologist at Dr Agarwal’s Hospital, says glaucoma is a disease that affects the optic nerve and leads to blindness with time. Other causes of blindness include cataract disease, refractive errors, diabetic retinopathy and childhood blindness. Statistics indicate that the disease accounts for over 15 per cent of blind cases in the country. The prevalence of glaucoma is estimated at five per cent in adults in the African population, while in Rwanda, glaucoma is the second cause of blindness. WHAT YOU SHOULD KNOW ABOUT THE CONDITION Nkuriye says the eye defect is when the optic nerve is damaged, causing one’s vision to narrow, adding that, glaucoma and diabetic retinopathy are traditionally more difficult diseases to deal with. He notes that glaucoma isn’t painful so people usually go for diagnosis when it’s in the bad stages. In most cases, Nkuriye says, glaucoma is genetic, and at times, caused by some medications such as steroids. It also mainly attacks people above the age of 40. For one to develop the condition, Dr Jeanette Muhongayire, an ophthalmologist based in Kigali, explains that a main cause is raised pressure inside the eye. “Glaucoma is a multi-factorial disease, which means that the causes are multiple, but genetics play an important role. It’s often linked to a buildup of pressure inside your eye. Glaucoma tends to be inherited and may not show until later in life,” she says. She explains that the increased pressure, called intraocular pressure, can damage the optic nerve, which transmits images to your brain. If the damage continues, glaucoma can lead to permanent vision loss. Without treatment, glaucoma can cause total permanent blindness within a few years. “Unfortunately, vision deterioration comes very late in the course of the disease, when the damage is significant and irreversible. No one should wait for the decline in vision to be checked,” says Nkuriye. Other causes, Muhongayire says, include a blunt or chemical injury to the eye, severe eye infection, blocked blood vessels inside the eye, and inflammatory conditions. In rare occasions, she says, sometimes eye surgery to correct another condition can bring it on. It usually affects both eyes, but it may be worse in one than the other. In case one experiences signs such as vision loss, readness in the eye, nausea or sometimes vomiting, as well as eye pain, Muhongayire says one should go for an eye checkup as soon as possible. WHO IS AT RISK? According to Nkuriye, anyone can be at risk of glaucoma, noting that one will not know if they are in the five per cent until they are checked. He says that the risk is higher in the descendants of a glaucoma patient. Everyone who is above 30 years of age should have at least one check-up per year to ensure that they are safe from the condition. “Most people with glaucoma have no early symptoms or pain; this makes it worse as one can live with the condition until it’s too late. You need to see your eye doctor regularly so that they can diagnose and treat glaucoma before long-term visual loss happens,” he advises. He points out that if one is over the age of 40 and has a family history of the disease, they should make an effort to get a complete eye exam from an eye doctor every one to two years. Nkuriye also says that if one has health problems like diabetes, or a family history of glaucoma or are at risk of other eye diseases, they need to go for a checkup more often. PREVENTION AND TREATMENT Christian Mudenge, an ophthalmologist at Galien Clinic in Kimironko, says that some types of glaucoma are called secondary glaucoma, which means their cause is known like traumatism to the eye; some types of medication, and these can be prevented. He notes that primary glaucoma is the one with no obvious cause and this one has no prevention. However, he says one can prevent blindness by early consultations and starting treatment before it is too late. “Glaucoma is the second leading cause of blindness. Unlike cataract (the first cause of blindness) which is completely curable, the treatment of glaucoma is to stop progression, not to cure the disease. The earlier the better,” says Nkuriye. He adds that though it’s hard to prevent the condition, the best way to go about it is to get diagnosed and seek treatment early enough. Mudenge notes that preventing overexposure to sunlight is also important and that one can do that by wearing sunglasses and hats when outdoors or are exposed to the scorching sun. Depending on the type of glaucoma one has, he says a physician can choose the right medication and treatment. When it comes to treatment, Mudenge says there are prescription eye drops, laser surgery, or microsurgery to treat the condition. For the drops, he explains that these can help either reduce the formation of fluid in the eye or increase its outflow. “The treatment however, comes with some side effects which may include allergies, redness, stinging, blurred vision, and irritated eyes. Whereas some glaucoma drugs may affect the heart and the lungs,” he says. For this reason, Mudenge advises that one should be sure to tell their physician the medications they use or are allergic to, to prevent any other complications that may arise. Another common treatment for glaucoma, Muhongayire says, is laser surgery; she explains that this procedure can slightly increase the flow of the fluid from the eye. She explains that with glaucoma, once vision is lost, there is no way it can be restored. However, the best option is to lower the eye pressure which can help preserve the sight a patient has. She adds that, in most cases, patients with glaucoma who strictly follow their treatment plan as requested by their ophthalmologists and ensure that they have regular eye exams, rarely go blind, unlike those who don’t. editorial@newtimes.co.rw

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Watch out for glaucoma